NURS FPX 4000 Assessment 3

Name

Capella university

NURS-FPX4000 Developing a Nursing Perspective

Prof. Name

Date

Escalating Global Health Issue: Opioid Epidemic

• The United States has witnessed dramatic growth in opioid misuse demises, with 70,630 fatalities in 2019 and even more in 2020, worsened by the indirect consequences of the COVID-19 epidemic (Keyes et al., 2022).

• Opioids are the primary driver of both fatal and non-fatal overdoses, beginning with prescription opioids, followed by a shift to heroin and synthetic opioids. An projected 6.8 to 7.7 million adults across the United States are presently affected by opioid use disorder (OUD) (Keyes et al., 2022).

• Persistent patient expectations and clinical pressures have contributed to the overprescribing of opioids, particularly for chronic pain and non-severe conditions, fueling the rise in misuse and dependence.

• Addressing the opioid crisis involves adopting safer prescribing protocols, limiting opioid exposure, expanding education, and integrating ethical, patient-centered methods to discomfort and OUD prevention (Price et al., 2021).

Autonomy in Opioid Epidemic

Definition: Patients have the authority to make sound decisions about their medical care, and healthcare providers must respect these personal preferences by ensuring they receive clear information before any treatment.

Implications for Practice in the Opioid Crisis:

• Patients sometimes seek opioids for pain management, even in situations where non-opioid alternatives may be safer and equally effective (Holt & Schwan, 2024).

• Healthcare professionals must honor patient autonomy while also providing accurate, evidence-based guidance on the risks and appropriate use of opioid medications.

• Respecting autonomy means informing patients about the potential for dependence, addiction, and long-term harm associated with opioid misuse, enabling them to make well-informed choices.

• Ethical dilemmas arise when patient expectations for pain relief challenge a clinician’s duty to prescribe opioids responsibly and prevent potential misuse or harm (Holt & Schwan, 2024).

Beneficence in Opioid Epidemic

Definition: Beneficence refers to the obligation to support a person’s welfare by taking steps that encourage healing, safety, and improved quality of life.

Application in the Opioid Epidemic:

• Prescribing opioids only when clinically justified ensures that patients receive adequate care while mitigating the risk of harm.

• Inappropriate opioid misuse can result in serious consequences, such as addiction, respiratory depression, or overdose, which runs counter to the principle of beneficence (Zacharoff, 2024).

• By limiting unnecessary opioid prescriptions, healthcare providers not only protect individual patients but also contribute to reducing opioid misuse in the broader community.

• Educating patients about the risks of opioid dependence and alternative pain relief options aligns with beneficence, empowering them to make safer, informed choices (Zacharoff, 2024).

Nonmaleficence in Opioid Epidemic

Definition: Nonmaleficence is the ethical duty to prevent inflicting any injury or damage, ensuring that healthcare providers take measures to avoid causing harm to patients.

Application in the Opioid Epidemic:

• Overprescribing opioids can lead to severe long-term consequences, such as addiction and overdose, which are more challenging and costly to treat.

• The harm from inappropriate opioid use includes both direct risks to the patient (e.g., overdose, respiratory depression) and indirect harm by contributing to the broader public health crisis of opioid misuse.

• Healthcare providers must carefully weigh the risks of opioid prescriptions against their potential benefits to minimize harm and ensure patient safety (Zacharoff, 2024).

• Nonmaleficence requires clinicians to avoid unnecessary opioid prescriptions that could lead to dependence, overdose, prolonged recovery, or worsen the patient’s condition.

Justice in Opioid Epidemic

Definition: Justice in healthcare involves ensuring impartial and equal care, as well as allocating resources in a manner that benefits all individuals fairly.

Application in the Opioid Epidemic:

• Equitable access to effective pain management, including alternatives to opioids, must be ensured, allowing all individuals to receive appropriate care when needed.

• Overuse of opioids, especially in wealthier populations or through self-medication, can reduce the availability of safe pain relief for others, disproportionately harming vulnerable groups (e.g., low-income patients or those with chronic conditions) (Wallace et al., 2021).

• Justice in healthcare involves intergenerational fairness: Safeguarding the efficacy of non-opioid pain management strategies for future patients by reducing opioid misuse today.

• Ethical justice requires policies that regulate opioid prescriptions and promote responsible prescribing practices, ensuring long-term access to effective treatments for all (Wallace et al., 2021).

The Role of Bias in Opioid Epidemic

• Bias affects both patients and healthcare providers in the context of opioid use. Patients have misconceptions about the efficiency of opioids for pain management, influencing their demands and treatment choices, which compromises their autonomy due to misinformation.

• Healthcare provider bias, such as prescribing opioids to avoid patient dissatisfaction or conflict, impacts beneficence by prioritizing immediate comfort over the long-term well-being of the patient (Fine et al., 2020).

• It threatens nonmaleficence, as overprescription of opioids leads to harm through increased risk of addiction, overdose, and long-term dependency. Provider bias exacerbates the issue by contributing to the broader public health crisis of opioid misuse (Fine et al., 2020).

• Bias undermines justice, leading to unequal access to appropriate pain management, with vulnerable populations being disproportionately affected by opioid overprescription and misuse.

• Addressing bias is crucial for ensuring decisions align with ethical principles, promoting responsible opioid use, and safeguarding both individual and public health.

Four Spheres of Care

• In healthcare, the four spheres of care—Wellness and Disease Prevention, Chronic Disease Management, Restorative Care, and Supportive Care—are vital in shaping and delivering services across the continuum of care (Giddens & Mullaney, 2023).

1. Wellness and Disease Prevention: Focuses on education, screenings, and early intervention to prevent opioid misuse and related health issues. Initiatives could include promoting safe opioid use, advocating for alternative pain management strategies.

2. Chronic Disease Management: Involves long-term care strategies for individuals with OUD and chronic diseases, ensuring ongoing monitoring, medication management, and support.

3. Restorative Care: Aims to restore function and improve quality of life for individuals recovering from opioid addiction and chronic diseases. This involves rehabilitation services, pain management strategies, and support to help patients regain independence.

4. Supportive Care: Provides emotional, psychological, and social support for patients dealing with opioid addiction and chronic diseases. This sphere includes counseling, mental health services, support groups, and family education to ensure that patients receive the holistic care needed for both physical and emotional recovery (Giddens & Mullaney, 2023).

Importance of Ethics in Chronic Disease Management and Opioid Epidemic

Understanding ethics is critical in chronic disease management, particularly in the setting of the opioid epidemic. In managing chronic pain, healthcare providers often face pressures to prescribe opioids, potentially contributing to misuse and addiction.

• Autonomy: Ensures patients are informed and involved in their treatment decisions, including alternatives to opioids. Supports patients in choosing chronic disease management strategies that align with their values and preferences.

• Beneficence: Promotes the best outcomes for patients by selecting non-harmful treatments for chronic disease, reducing reliance on opioids. Involves prescribing pain management options that improve patients’ quality of life while abating risks (Zacharoff, 2024).

• Nonmaleficence: Prevents harm by avoiding overprescription of opioids, reducing the risk of misuse, addiction, and overdose. Ensures that chronic disease management strategies do not cause long-term harm to the patient or contribute to the opioid epidemic.

• Justice: Promotes equitable access to chronic disease management alternatives, ensuring all patients, regardless of background, receive appropriate care. Supports the fair distribution of healthcare resources and addresses disparities in opioid use and addiction treatment (Wallace et al., 2021). In managing chronic conditions, integrating ethics is essential to reduce opioid misuse and preserve the effectiveness of pain management strategies for future generations.

Conclusion

• The opioid widespread is a life-threatening matter that needs the extensive application of ethical and comprehensive strategies. Healthcare professionals who apply the four moral principles can balance individual patient care needs with collective efforts to combat opioid misuse and addiction.

• Addressing biases between patients and healthcare providers is essential to ensure responsible prescribing, promote fair pain management practices, and reduce unnecessary opioid consumption.

• The correct integration of ethical thinking in chronic disease management highlights the importance of maintaining ethical standards, which help prevent opioid misuse and ensure the responsible use of pain relief treatments for future generations.

References

Fine, D. R., Herzberg, D., & Wakeman, S. E. (2020). Societal biases, institutional discrimination, and trends in opioid use in the USA. Journal of General Internal Medicine, 36(3). https://doi.org/10.1007/s11606-020-05974-0

Giddens, J. F., & Mullaney, S. (2023). Incorporating the AACN Essentials “spheres of care” into nursing curricula. Journal of Professional Nursing, 47, 9–14. https://doi.org/10.1016/j.profnurs.2023.03.01

NURS FPX 4000 Assessment 3

Holt, G., & Schwan, B. (2024). Autonomy-based obligations to patients in the emergency department following opioid overdose. The American Journal of Bioethics, 24(5), 56–58. https://doi.org/10.1080/15265161.2024.2329252

Keyes, K. M., Rutherford, C., Hamilton, A., Barocas, J. A., Gelberg, K. H., Mueller, P. P., Feaster, D. J., El-Bassel, N., & Cerdá, M. (2022). What is the prevalence of and trend in opioid use disorder in the United States from 2010 to 2019? Using multiplier approaches to estimate prevalence for an unknown population size. Drug and Alcohol Dependence Reports, 3(100052), 100052. https://doi.org/10.1016/j.dadr.2022.100052

Price, S. M., O’Donoghue, A. C., Rizzo, L., Sapru, S., & Aikin, K. J. (2021). Opioid education and prescribing practices. Journal of the American Board of Family Medicine: JABFM, 34(4), 802–807. https://doi.org/10.3122/jabfm.2021.04.200610

Wallace, B., MacKinnon, K., Strosher, H., Macevicius, C., Gordon, C., Raworth, R., Mesley, L., Shahram, S., Marcellus, L., Urbanoski, K., & Pauly, B. (2021). Equity-oriented frameworks to inform responses to opioid overdoses: A scoping review. JBI Evidence Synthesis, 19(8), 1760–1843. https://doi.org/10.11124/jbies-20-00304

Zacharoff, K. L. (2024). Ethical decision making in pain management. Pain, Drugs, and Ethics, 111–122. https://doi.org/10.1007/978-3-031-63018-7_9